Methicillin-resistant Staphylococcus aureus: prevalence of and risk factors associated with colonization of patients on admission to the Teaching hospital, Karapitiya

M R P Kurukulasooriya,C W Woods,T Ostbye,A De S Nagahawatte,B P Nicholson,C K Bodinayake,W M D G B Wijayaratne,L G Tillekeratne,A D De Silva

doi:10.4038/jur.v6i2.7878

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) causes a substantial burden of community-acquired and nosocomial infection. Prior colonization with MRSA is a recognized risk factor for MRSA infection. The study aimed to assess the prevalence of and risk factors for MRSA colonization at admission to surgical, medical and orthopaedic wards of Teaching Hospital, Karapitiya, Sri Lanka. From September 2016 to March 2017, consecutive patients admitted to orthopaedic wards and every fifth patient admitted to medical and general surgical wards were enrolled. A nasal swab was collected from the anterior nares within 24 hours of admission and tested using standard microbiologic procedures. Clinical and demographic data were collected. A total of 502 patients were enrolled, including 152 medical, 201 general surgical, and 149 orthopaedic patients. The median age was 45 years (range 3- 85 years) and 58% of patients were male. At admission, 31 (6.2%) were colonized with MRSA. Colonization prevalence was higher in orthopaedic (18, 12.1%) compared to medical (6, 4.0%) and general surgical (7, 3.5%) patients, p=0.002. Patients colonized with MRSA on admission were more likely to be children

Highlights

Staphylococcus aureus is a pathogenic gram-positive bacterium which can cause a broad variety of diseases, ranging from minor infections of the skin to severe post-operative wound infections (Deurenberg et al, 2001)
Colonization prevalence was higher in orthopaedic (18,12.1%) compared to medical (6, 4.0%) and general surgical (7, 3.5%) patients, p=0.002
Methicillin-resistant Staphylococcus aureus (MRSA) colonization was highest among orthopaedic patients

Summary

Introduction

Staphylococcus aureus is a pathogenic gram-positive bacterium which can cause a broad variety of diseases, ranging from minor infections of the skin to severe post-operative wound infections (Deurenberg et al, 2001). 30% of humans are asymptomatic nasal carriers of S. aureus. S. aureus is an extraordinarily adaptable pathogen with a proven ability to develop resistance (Chamber and Deleo, 2009). Infections due to MRSA may be associated with worse outcomes, including a greater risk of death, than infections due to methicillin-susceptible S. aureus (Melzer et al, 2003). It can be usually preceded by asymptomatic nasal colonization, which is recognized as a significant risk factor for infection. Colonized individuals can act as reservoirs in the spread of the organism (Chamber and Deleo, 2009).

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